Obesity Surgery

, Volume 23, Issue 9, pp 1345–1353

Intensive Medical Weight Loss or Laparoscopic Adjustable Gastric Banding in the Treatment of Mild to Moderate Obesity: Long-Term Follow-up of a Prospective Randomised Trial

  • Paul E. O’Brien
  • Leah Brennan
  • Cheryl Laurie
  • Wendy Brown
Original Contributions

Abstract

Background

Proven short-term effectiveness of obesity therapy should be re-evaluated in the long-term. The objective of this paper is to determine the long-term (10 years) outcome for patients from a randomised controlled trial (RCT).

Methods

A RCT in 2002 compared laparoscopic adjustable gastric band (LAGB) for obesity with non-surgical therapy. Follow-up has been conducted at 10 years. Eighty patients (BMI 30–35) were randomised to a non-surgical or a surgical program. Outcome data are available on 37 (92.5 %) of the surgical patients and 27 (62.5 %) of the non-surgical patients at 10 years.

Results

Weight change, the metabolic syndrome, quality of life, adverse events and direct costs of the surgical cohort were the main results of the study. A durable weight loss is present in the surgical group with a mean (SD) 10-year weight loss of 14.1 (7.7) kg (63.4 % EWL), better than the non-surgical group (mean (SD) = 0.4 (10.5) kg; p < 0.001). The metabolic syndrome was reduced from 14 to 4 of the 37 patients who completed 10 years within the LAGB groups. Proximal gastric enlargements occurred in 17 (30 %) of the 57 who had LAGB and removal of the band occurred in 7 (12 %). The annual maintenance costs including additional surgery was AUD $765 per patient per year.

Conclusions

Bariatric surgery with the LAGB can achieve long-term weight reduction which is better than a program of non-surgical therapy. There is also a sustained reduction of the metabolic syndrome. There is a significant maintenance requirement after LAGB.

Keywords

Long-term weight loss LAGB Class I obesity Metabolic syndrome RCT 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Paul E. O’Brien
    • 1
    • 2
  • Leah Brennan
    • 1
  • Cheryl Laurie
    • 1
  • Wendy Brown
    • 1
  1. 1.Centre for Obesity Research and EducationMonash UniversityMelbourneAustralia
  2. 2.Centre for Obesity Research and EducationMonash UniversityMelbourneAustralia

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